Much attention has focused on the effects of leptin as a central satiety agent. There is now a significant amount of evidence that leptin is active in the periphery. This review focuses on the ability of leptin to modify insulin sensitivity, tissue metabolism, stress responses, and reproductive function. Leptin's effect on several of these systems is mediated via the hypothalamic-pituitary axis. Therefore, although in vitro studies provide evidence for direct effects on specific tissues and metabolic pathways, it is essential to consider the interactions between leptin and other regulatory factors in vivo. Little is known about the regulation of peripheral receptor expression or the production of binding proteins. Both of these factors determine the bioactivity of circulating leptin and have the potential to induce a peripheral resistance to leptin, similar to the central "leptin resistance" observed in obese subjects. Future research will clarify which of the endocrine and metabolic actions of peripheral leptin are of physiological relevance and which should be considered a pharmacological manipulation.

中文翻译：

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瘦素-不仅仅是饱食感信号。

许多注意力集中在瘦素作为中央饱腹感剂的作用上。现在有大量证据表明瘦素在外周具有活性。这篇综述着重于瘦素改变胰岛素敏感性，组织代谢，应激反应和生殖功能的能力。瘦素对其中一些系统的作用是通过下丘脑-垂体轴介导的。因此，尽管体外研究提供了对特定组织和代谢途径直接作用的证据，但必须考虑瘦素与体内其他调节因子之间的相互作用。关于外围受体表达的调节或结合蛋白的产生知之甚少。这两个因素都决定了循环中瘦素的生物活性，并具有诱导对瘦素的外周抗性的潜力，类似于在肥胖受试者中观察到的中心“瘦素抗性”。未来的研究将阐明外周瘦素的内分泌和代谢作用中哪些与生理有关，哪些应被视为药理学操作。